[A case of temporal arteritis associated with polymyalgia rheumatica and subclinical Sjögren's syndrome].
A case of temporal arteritis (TA) associated with polymyalgia rheumatica (PMR) and subclinical Sjögren's syndrome (sub SjS) was presented in this paper. A 76 year-old-male was admitted with headache, fever and weight loss in April 1987. Myalgia of upper extremities and of thighs developed during the past two months before admission. He also had noticed bilateral wrist pain. Physical examination revealed slight cord-like thickening of left temporal artery with tenderness. Cerebral angiography disclosed narrowing of frontal and parietal branches of left temporal artery. Temporal artery biopsy was consistent with TA. Diagnosis of PMR was made by Bird's diagnostic criteria. Although sicca symptoms were not seen, sialography revealed moderate sialectasis. Pathological finding of salivary gland was compatible with sub SjS. Possibility of occult lymphoma was eliminated by CT scanning or myelogram. Laboratory evaluation disclosed slight anemia, leukocytosis and thrombocytosis. Blood chemistry showed no abnormal finding except for hyperfibrinogenemia. Serological studies indicated positive C-reactive protein and slight elevation of alpha 2 and beta globulin fractions of serum protein. Either rheumatoid factors, antinuclear antibodies, anti-smooth muscle antibodies, cryoglobulin or circulating immune complexes were not detected. The HLA-B8 and DR3, frequently detected in TA and SjS, were not identified. Tuberculin test was negative. These results suggested that immunological aberration not caused by genetic factors but by senescence would induce presence of TA associated with both PMR and sub SjS.
Kohriyama
K
K
Department of Internal Medicine, Kobe West Municipal Hospital.
Kohno
A
A
Arimori
S
S
D000368:Aged; D013700:Giant Cell Arteritis / Q000150:complications / Q000473:pathology*; D006801:Humans; D008297:Male; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000150:complications / Q000473:pathology*